Skip to main content

Bulimia Nervosa

Image
By

A young lady of twenty-eight, came to the psychiatric outpatient department with an irresistible urge to overeat followed by feelings of guilt and self-induced vomiting. She also uses laxatives to compensate for overeating. She wants to know if this is a normal pattern of behaviour or an illness?  

  1. How will you respond to her? 
  2. What is the likely diagnosis? 
  3. Outline management steps for this patient according to the NICE stepped-care approach.    

It is likely you are suffering from an eating disorder, in which people repeatedly experience an irresistible urge to eat an enormous amount of food in a brief time. The associated feelings of guilt and efforts to counteract the resultant We would like to carry out a detailed assessment to confirm the diagnosis. But that you are cannot control the episodes implies that the behaviour may not be normal.  

Diagnosis 

  • Bulimia nervosa  

If there was evidence of BMI being lower than 17.5, or recent severe weight loss, we would diagnose anorexia nervosa instead. 

Outline Of Management Steps  

  • Recognition (confirmation of diagnosis) and assessment 

  • Multidisciplinary supportive treatment 

  • Psychological treatment 

  • Weight restoration  

  • Treatment of comorbidities 

Labels:

Comments

Post a Comment

Your Thoughts?

Popular posts from this blog

ADVOKATE: A Mnemonic Tool for the Assessment of Eyewitness Evidence

By
ADVOKATE: A Mnemonic Tool for Assessment of Eyewitness Evidence A tool for assessing eyewitness  ADVOKATE is a tool designed to assess eyewitness evidence and how much it is reliable. It requires the user to respond to several statements/questions. Forensic psychologists, police or investigative officer can do it. The mnemonic ADVOKATE stands for: A = amount of time under observation (event and act) D = distance from suspect V = visibility (night-day, lighting) O = obstruction to the view of the witness K = known or seen before when and where (suspect) A = any special reason for remembering the subject T = time-lapse (how long has it been since witness saw suspect) E = error or material discrepancy between the description given first or any subsequent accounts by a witness.  Working with suspects (college.police.uk)
Post a Comment
Read more

ICD-11 Criteria for Anorexia Nervosa (6B80)

By
ICD-11 Criteria for Anorexia Nervosa (6B80) Anorexia Nervosa is characterised by significantly low body weight for the individual’s height, age and developmental stage that is not due to another health condition or to the unavailability of food. A commonly used threshold is body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under 5th percentile in children and adolescents. Rapid weight loss (e.g. more than 20% of total body weight within 6 months) may replace the low body weight guideline as long as other diagnostic requirements are met. Children and adolescents may exhibit failure to gain weight as expected based on the individual developmental trajectory rather than weight loss. Low body weight is accompanied by a persistent pattern of behaviours to prevent restoration of normal weight, which may include behaviours aimed at reducing energy intake (restricted eating), purging behaviours (e.g. self-induced vomiting, misuse of laxatives), and behaviours aimed at incr
Post a Comment
Read more

ICD-11 Criteria for Depression (Recurrent Depressive Disorder) 6A71

By
ICD-11 Criteria for Depression (Recurrent Depressive Disorder) 6A71 Recurrent depressive disorder is characterised by a history or at least two depressive episodes separated by at least several months without significant mood disturbance. A depressive episode is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a Bipolar disorder. Inclusions:                Seasonal depressive disorder Exclusions:               Adjustment disorder (6B43) Bipolar or related disorders (BlockL2‑6A6) Sing
Post a Comment
Read more